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J Díaz

Publications and source records attributed to J Díaz.

At least 109 records · Page 6Linked to original sources
PubMed1994

[A case of uterine leiomyoma with pulmonary metastasis].

In a 34-years-old patient complaining about persistent dry cough, multiple bilateral pulmonary nodules were observed. The extremely good condition of the patient and the history of resection four years before of an uterine myoma suggested a pulmonary leiomyomatosis. The hystological study after a pulmonary segmentomy confirmed this diagnostic suspicion. The presence of benign pulmonary metastasis in an uterine leiomyoma is a very rare complication. We review the literature therapeutic aspects of this interesting entity.

Adult↗
PubMed1993

Quality of care in family planning in Latin America.

The majority of family planning programs in Latin America have been implemented in response to the region's population growth and aimed mainly at obtaining quantitative results, leaving quality, from the user's point of view, in second place. Recent decades have witnessed an increasing concern for quality of care in family planning because most researchers and service providers began to realize that when contraceptive methods are delivered without maintaining high quality levels, continuation rates are usually low and the image of methods and services is impaired. This paper reviews the level of quality of services in family planning in Latin America following Judith Bruce's framework and proposes, some activities that may improve it. The analysis found severe deficiencies in almost all the elements mentioned by Bruce, mainly in choice, technical competence, and mechanisms for improving continuity. The authors propose that to improve quality, services should (a) generate top management commitment to quality, (b) stay close to the client/user, (c) improve work conditions of providers/health workers, (d) measure quality, and (e) reward quality. The authors' conclusions are that (a) better quality services lead to better program results, (b) high quality is cost-effective, (c) managerial commitment is critical to improvement of quality, and (d) quality of care is not a luxury; it is necessary and possible in all settings.

Clinical Competence↗
PubMed1993

Performance of the copper T 200 in parous adolescents: are copper IUDs suitable for these women?

The clinical performance of a cohort of 995 parous adolescents, first-time users of the T-Cu 200B was studied and compared with a cohort of paired controls 10 years older, of the same parity. Life-table analysis showed that pregnancy, expulsion rates, as well as removals for bleeding and/or pain were higher in adolescents but within ranges already reported in the literature on this device. Removals for infection were few and not significantly different. Although the clinical performance of the T-Cu 200B in adolescents is not as good as in older women, the performance is similar or better than that reported for other reversible methods in this age group. Our conclusion is that IUDs should not be contraindicated for parous adolescents as long as adequate counseling, screening of risk factors, skillful insertion and follow-up are provided.

Adolescent↗
PubMed1993

Evaluation of the clinical performance of a levonorgestrel-releasing IUD, up to seven years of use, in Campinas, Brazil.

The clinical performance of a levonorgestrel IUD, releasing 20 mcg/day, used by 293 women at the Family Planning Clinic of the State University of Campinas, was evaluated up to the end of the seventh year of use. No pregnancies occurred in 899 women-years of observation. The cumulative removal rate for amenorrhea or severe hypomenorrhea was 15.7 per 100 women at seven years. The expulsion rate was within ranges observed with copper IUDs in the same clinic. The continuation rate was 49.5% at three years and 23.7 at seven years. The cumulative loss to follow-up rate was 13.7% at seven years. The effectiveness, good continuation rate, and reduction of the amount of blood loss make this device appropriate to be offered to Brazilian women, as an additional contraceptive option.

Adult↗
PubMed1993

A Latin American experience with levonorgestrel IUD.

The intrauterine contraceptive device is an effective, safe and convenient contraceptive method. Its use in less developed countries has been limited by the increase in menstrual blood loss, an important issue in populations with a high prevalence of anaemia. The levonorgestrel releasing IUD (LNg IUD) is the first device which is at the same time highly effective, long-lasting and reduces the blood loss during menstruation. This device was tested in 200 volunteers in Santo Domingo, Dominican Republic and in 381 in Campinas, Brazil. The cumulative pregnancy rate was 0 up to 7 years of use. The reduced bleeding was confirmed, and ferritin concentration among long-term users of the LNg IUD was significantly higher than among copper IUD users and controls using no contraception. Mean levonorgestrel plasma levels remained above 100 pg/ml until the seventh year of use. Endometrial histology showed mainly a marked reduction in epithelial growth, with variable signs of decidualization of the stroma. The most important reason for discontinuation in the two centres was amenorrhea, with cumulative rates of 10 and 15, respectively. This device should be very well accepted and will have a clear niche among reversible contraceptives, when available.

Adult↗
PubMed1993

[Importance of the colon in intestinal adaptation. Study with the proliferating cell nuclear antigen].

Proliferating cell nuclear antigen (PCNA) is an auxiliary protein to DNA polymerase delta necessary for tissue cellular proliferation. The colon releases several peptides or hormones which are probably related to intestinal proliferation. Colonic resection determines adaptive changes in the remnant bowel. In the present study, proliferative changes after colectomy were studied by means of the murine monoclonal PC10 antibody. A control group (n = 10 rats) and a 75% proximal colon resection group (n = 10 rats) were studied. 14 days after resection, jejunal, ileal and colon samples were taken and assayed for PCNA. Relationship between immunostained nuclei and the total number of nuclei was determined. The three intestinal segments showed statistically significant increases (p < 0.001) in the number of immunostained nuclei. PCNA proliferative index was greater in the remnant large bowel.

Adaptation, Physiological↗
PubMed1992

Long-term evaluation of the clinical performance of the TCu200B and the TCu380A in Campinas, Brazil.

The clinical performance of the TCu200B and TCu380A was evaluated by life table analysis in a cohort of women who wore an IUD from July 1979 to July 1982. This paper presents the results up to five years of use. No significant differences in age and parity were found between the users in the two groups. Overall performance was very good with both models. The cumulative continuation rate was 83.6, 60.9 and 46.1 at one, three and five years with the TCu200 and 84.0, 64.7 and 49.3 with the TCu380A in the same periods. Differences between both IUDs were not significant. The pregnancy rate was lower with the TCu380A and reached statistical significance from the fourth year on. The authors conclude that both IUDs presented very good performance, the TCu380A being more effective, the only significant difference observed.

Adult↗
PubMed1992

Evaluation of the performance of the copper T380A IUD up to ten years. Is this IUD a reversible but potentially permanent method?

The clinical experience of a cohort of 340 women using a TCu380A IUD for up to 10 years at the Family Planning Clinic of the State University of Campinas, Brazil was evaluated by life-table analysis. Removals for medical reasons were more frequent during the first year of use, while from the third year on, removals for personal reasons were more frequent. Expulsions were concentrated in the first two years of use, and none were detected after the fourth. Gross pregnancy rate accumulated to 2.0, 2.8 and 5.3 and continuation rate was 64.2, 43.4 and 27.8 per 100 women at three, six and ten years of use, respectively. The effectiveness of the device did not decrease significantly after the eighth year of use and it could be considered a reversible but potentially permanent method.

Adolescent↗
PubMed1992

[Acute-phase reactants in sepsis].

In 71 patients with fever and bacteremia without complications, a prospective study of acute-phase reactants is done. Raises in haptoglobin, ceruloplasmin, alpha-1-antitrypsin, protein C, beta-2-microglobulin, IgA and ferritin serum levels, together with leucocytosis and GSR, were very significant when diagnosis was done. Fibronectin, sideremia and transferrin were lowered. After 3 and 6 days of treatment haptoglobins, alpha-1-antitrypsin, protein C, ferritin, leucocytosis and GSR are lowered, while immunoglobulins, sideremia, transferrin and fibronectin raised, the latter until normalization. Fibronectin as well as changes in iron metabolism were very reliable parameters of inflammation and favorable evolution.

Acute-Phase Reaction↗
PubMed1992

[A preliminary report on penile cancer in the Instituto Oncológico Nacional from 1982 to 1990].

Cancer of the penis is not to common disease and its incidence varies between 0.5 and 5%. In Panama, 70 cases were registered from 1982 to 1990 and it is considered an important social problem in the rural population. Phimosis and poor hygiene are important factors in its etiology. Of 70 cases seen at the National Institute of Oncology from 1982 to 1990, 51 cases were analyzed comparing two approaches in regard to lymph node metastasis: (1) an expectant approach in those without clinically suspected lymph node metastasis, and (2) lymph node biopsy using the Cabañas technique in those clinically suspected followed by lymphadenectomy if the biopsy was positive. The high percentage biopsies (Cabañas technique) as well as the significant morbidity (31.6%) in these patients, compared with no morbidity and the high accuracy of the expectant approach (90%) lead the authors to recommend the Cabañas biopsy technique only for patients of low educational level and difficult follow-up as outpatients. Others patients should be followed clinically for signs of tumor activity.

Age Factors↗